AMA still focused on increased tobacco control

Honolulu -- The AMA House of Delegates at its Interim Meeting last month renewed its commitment to support tobacco-control efforts by aiming new policy positions at generating more funding and protecting existing cash sources.

Specifically, the house directed the AMA to oppose state government efforts toward securitization of tobacco settlement funds unless the new funds are dedicated to reducing tobacco use. Securitization involves selling the rights to future tobacco settlement dollars. The AMA condemned any use of these funds to alleviate state budget problems, according to a house-endorsed Board of Trustees report.

"All too frequently the money does not go to tobacco control," said AMA Trustee Joseph Heyman, MD. "We are strongly opposed to this."

This position was a response to the growing number of states opting to use securitization of settlement funds to pay for capital projects, school construction, economic development, water resource projects and, most commonly, to balance state budgets.

The house also directed the AMA to study the appropriate use of tobacco taxes. Increased taxes are widely acknowledged as a significant deterrent to starting to smoke as well as an incentive to quit. There is, however, a great deal of debate about how the resulting monies should be spent.

"This is a very complex issue," said Lawrence L. Altaker, MD, a psychiatrist and Pennsylvania delegate.

Some delegates felt the resources should be earmarked for anti-tobacco programs, although some expressed concern that governments wouldn't be interested in imposing the taxes with such restrictions. Others supported using these funds for broader health initiatives.

Pennsylvania, for example, is discussing the possibility of using the revenues to alleviate some of the cost burden the liability crisis is causing for physicians. Other states have used the money to fund direct health care.

Meanwhile, the AMA will continue to publish annual tobacco reports in response to demands from members, despite the sunset of its flagship tobacco-control program, the SmokeLess States National Tobacco Policy Initiative, in May.

The AMA's Action Team on Alcohol and Health, an initiative to reduce underage drinking, pledged to work toward streamlining AMA alcohol policies. The team will use successful tobacco-control policies as its model.

"It's not cool to smoke anymore," said Lloyd Gordon, III, MD, chair of the initiative and a specialist in addiction medicine. "We want teenagers to say it's not cool to drink."